scholarly journals Barriers and opportunities for management of shared sanitation facilities in low-income settlements in Kenya

2020 ◽  
Author(s):  
Sheillah Simiyu ◽  
Raphael M. Kweyu ◽  
Prince Antwi-Agyei ◽  
Kwaku A. Adjei
Keyword(s):  
Low Income ◽  
Sub Saharan Africa ◽  
Group Discussions ◽  
Open Defecation ◽  
Key Stakeholders ◽  
Social Opportunities ◽  
Risk Of Disease ◽  
Sub Saharan ◽  
Barriers And Opportunities ◽  
Depth Interviews

Abstract Background Sharing of sanitation is commonly being practiced in low income areas in Sub Saharan Africa. However, the JMP categorizes shared sanitation as a limited sanitation service due to concerns of cleanliness and safety. The shared facilities are often the only option available for most of the residents in low income settlements, and improving the management is key to reducing open defecation and risk of disease. This study sought to investigate barriers and opportunities for improved management of shared sanitation in low income settlements of Kisumu in Kenya.Methods Thirty nine In-depth interviews and 11 Focus group discussions were held with residents, including tenants and landlords. Analysis followed a thematic approach to define the problem, specify the target behaviour and define what needs to change.Results Pit latrines were commonly shared among landlords and tenants. Shared sanitation facilities were unclean due to poor use and lack of cleaning. As respondents specified attributes of clean and useable shared toilets, they also identified behavioural, physical, social and motivational opportunities for improvement, and the key stakeholders that should be involved in shared sanitation interventions. Social opportunities such as clear cleaning plans, communication, and problem solving mechanisms between landlords and tenants were most commonly reported.Conclusion The results highlight the need to focus on social aspects for improvement of shared sanitation management in low income settlements. Through a social approach, shared sanitation facilities can be managed appropriately to afford the millions of low income dwellers an opportunity to access sanitation. This study provides further evidence on approaches for improved management of shared sanitation facilities in line with the JMP’s recommendation for well managed shared facilities.

scholarly journals Barriers and opportunities for cleanliness of shared sanitation facilities in low-income settlements in Kenya

2020 ◽  
Author(s):  
Sheillah Simiyu ◽  
Raphael M. Kweyu ◽  
Prince Antwi-Agyei ◽  
Kwaku A. Adjei
Keyword(s):  
Low Income ◽  
Sub Saharan Africa ◽  
Group Discussions ◽  
Open Defecation ◽  
Social Approach ◽  
Target Behaviour ◽  
Risk Of Disease ◽  
Sub Saharan ◽  
Barriers And Opportunities ◽  
Depth Interviews

Abstract Background: Sharing of sanitation is commonly being practiced in low income areas in Sub Saharan Africa. However, shared sanitation is categorized as a limited sanitation service, and they may therefore not count towards achieving the global goals. These shared facilities are often the only option available for most residents in low income settlements, and improving their cleanliness and overall management is key to reducing open defecation and risk of disease. This study sought to investigate barriers and opportunities for improved cleanliness of shared sanitation in low income settlements of Kisumu in Kenya. Methods: Thirty-nine In-depth interviews and 11 focus group discussions were held with residents, who were mainly tenants and landlords. Analysis followed a thematic approach to define the problem, specify the target behaviour and define what needs to change. Results: Sanitation facilities were mainly pit latrines commonly shared among landlords and tenants. Participants singled out behavioural (poor use of the shared toilets) and social (lack of cooperation in cleaning) challenges that led to unclean shared toilets. Available opportunities for improvement included instituting clear cleaning plans, improving communication among users, and enhanced problem solving mechanisms between landlords and tenants. These approaches could form the basis for designing intervention strategies for improving the cleanliness of shared sanitation. Conclusion: The results highlight the need to focus on social aspects for improvement of shared sanitation cleanliness in low income settlements. Through a social approach, shared sanitation facilities can be managed appropriately to afford the millions of low income residents an opportunity to access sanitation. This study provides further evidence on approaches for improved management of shared sanitation facilities in line with the JMP’s recommendation for high quality shared facilities.

scholarly journals Barriers and opportunities for management of shared sanitation facilities in low-income settlements in Kenya

2020 ◽  
Author(s):  
Sheillah Simiyu ◽  
Raphael M. Kweyu ◽  
Prince Antwi-Agyei ◽  
Kwaku A. Adjei
Keyword(s):  
Low Income ◽  
Monitoring Program ◽  
Sub Saharan Africa ◽  
Group Discussions ◽  
Social Challenges ◽  
Risk Of Disease ◽  
Joint Monitoring ◽  
Sub Saharan ◽  
Barriers And Opportunities ◽  
Depth Interviews

Abstract Background: Sharing of sanitation is commonly being practiced in low income areas in Sub Saharan Africa. However, the Joint Monitoring Program (JMP) categorizes shared sanitation as a limited sanitation service. These shared facilities are often the only option available for most of the residents in low income settlements, and improving their management is key to reducing open defecation and risk of disease. This study sought to investigate barriers and opportunities for improved management of shared sanitation in low income settlements of Kisumu in Kenya. Methods: Thirty-nine In-depth interviews and 11 focus group discussions were held with residents, who mainly included tenants and landlords. Analysis followed a thematic approach to define the problem, specify the target behaviour and define what needs to change. Results: Pit latrines were commonly shared among landlords and tenants. Shared sanitation facilities were unclean due to poor use and lack of cleaning. Participants identified behavioural challenges such as poor use of the shared toilets, and social challenges such as lack of cooperation in cleaning. These results led to identification of opportunities for improvement such as instituting clear cleaning plans, communication among users, and problem solving mechanisms between landlords and tenants. These approaches could form the basis for designing intervention strategies for improving the management of shared sanitation. Conclusion: The results highlight the need to focus on social aspects for improvement of shared sanitation management in low income settlements. Through a social approach, shared sanitation facilities can be managed appropriately to afford the millions of low income dwellers an opportunity to access sanitation. This study provides further evidence on approaches for improved management of shared sanitation facilities in line with the JMP’s recommendation for high quality shared facilities.

scholarly journals Barriers and opportunities for cleanliness of shared sanitation facilities in low-income settlements in Kenya

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Sheillah N. Simiyu ◽  
Raphael M. Kweyu ◽  
Prince Antwi-Agyei ◽  
Kwaku A. Adjei
Keyword(s):  
Low Income ◽  
Sub Saharan Africa ◽  
World Health ◽  
Group Discussions ◽  
Kisumu City ◽  
Risk Of Disease ◽  
Joint Monitoring ◽  
Sub Saharan ◽  
Barriers And Opportunities ◽  
Depth Interviews

Abstract Background The sharing of sanitation facilities is a common practice in low-income areas in sub-Saharan Africa. However, shared sanitation is currently categorized as a limited sanitation service, and may therefore not count towards meeting the global goals. These shared facilities are often the only option available for most residents in low-income settlements, and improving their cleanliness and overall management is key to reducing open defecation and risk of disease. This study sought to investigate barriers and opportunities for improved cleanliness of shared sanitation facilities in low-income settlements of Kisumu city, Kenya. Methods Thirty-nine in-depth interviews and 11 focus group discussions were held with residents – mainly tenants and landlords – of a low-income settlement in Kisumu. Analysis followed a thematic approach to define the problem, specify the target behaviour and identify the changes needed. Results Sanitation facilities were mainly pit latrines, typically shared among landlords and tenants. Participants singled out behavioural (poor use of the shared toilets) and social (lack of cooperation in cleaning) challenges that led to unclean shared toilets. Available opportunities for improvement included instituting clear cleaning plans, improving communication among users, and enhanced problem-solving mechanisms between landlords and tenants. These approaches could form the basis for designing intervention strategies for improving the cleanliness of shared sanitation facilities. Conclusion The results highlight the need to focus on social aspects for improvement of cleanliness in shared sanitation facilities in low-income settlements. Through a social approach, shared sanitation facilities can be managed appropriately to provide the millions of low-income residents in Kenya an opportunity to access sanitation. This study provides further evidence on approaches for improved management of shared sanitation facilities in line with the World Health Organization’s (WHO) Joint Monitoring Program’s (JMP) recommendation for high quality shared facilities.

scholarly journals Barriers and opportunities for cleanliness of shared sanitation facilities in low-income settlements in Kenya

2020 ◽  
Author(s):  
Sheillah Simiyu ◽  
Raphael M. Kweyu ◽  
Prince Antwi-Agyei ◽  
Kwaku A. Adjei
Keyword(s):  
Low Income ◽  
Sub Saharan Africa ◽  
World Health ◽  
Group Discussions ◽  
Kisumu City ◽  
Risk Of Disease ◽  
Joint Monitoring ◽  
Sub Saharan ◽  
Barriers And Opportunities ◽  
Depth Interviews

Abstract Background: The sharing of sanitation facilities is a common practice in low-income areas in sub-Saharan Africa. However, shared sanitation is currently categorized as a limited sanitation service, and may therefore not count towards meeting the global goals. These shared facilities are often the only option available for most residents in low-income settlements, and improving their cleanliness and overall management is key to reducing open defecation and risk of disease. This study sought to investigate barriers and opportunities for improved cleanliness of shared sanitation facilities in low-income settlements of Kisumu city, Kenya. Methods: Thirty-nine in-depth interviews and 11 focus group discussions were held with residents – mainly tenants and landlords – of a low-income settlement in Kisumu. Analysis followed a thematic approach to define the problem, specify the target behaviour and identify the changes needed. Results: Sanitation facilities were mainly pit latrines, typically shared among landlords and tenants. Participants singled out behavioural (poor use of the shared toilets) and social (lack of cooperation in cleaning) challenges that led to unclean shared toilets. Available opportunities for improvement included instituting clear cleaning plans, improving communication among users, and enhanced problem-solving mechanisms between landlords and tenants. These approaches could form the basis for designing intervention strategies for improving the cleanliness of shared sanitation facilities. Conclusion: The results highlight the need to focus on social aspects for improvement of cleanliness in shared sanitation facilities in low-income settlements. Through a social approach, shared sanitation facilities can be managed appropriately to provide the millions of low-income residents in Kenya an opportunity to access sanitation. This study provides further evidence on approaches for improved management of shared sanitation facilities in line with the World Health Organization’s (WHO) Joint Monitoring Program’s (JMP) recommendation for high quality shared facilities

scholarly journals A cross-country qualitative study on contraceptive method mix: contraceptive decisionmaking among youth

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Lynette Ouma ◽  
Burcu Bozkurt ◽  
Jill Chanley ◽  
Christine Power ◽  
Ronald Kakonge ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Contraceptive Method ◽  
Full Range ◽  
Sub Saharan Africa ◽  
Community Members ◽  
Group Discussions ◽  
Full Spectrum ◽  
Key Stakeholders ◽  
Sub Saharan ◽  
Method Mix

Abstract Background Youth ages 15 to 24, who comprise a large portion of sub-Saharan Africa, face a higher burden of unmet contraceptive need than adults. Despite increased international and national commitments to improving young people’s access to contraception, significant barriers impede their access to a full range of methods. To further explore these barriers among youth in Kenya, Nigeria, and Uganda, we conducted a qualitative study to capture the challenges that affect contraceptive method decisionmaking and complicate youth access to the full method mix. Methods To understand factors that impact young people’s contraceptive decisionmaking process across all three countries, we conducted a total of 35 focus group discussions with 171 youth ages 15 to 24 and 130 in-depth interviews with key stakeholders working in youth family planning. Questionnaires aligned with the High Impact Practices in Family Planning’s elements of adolescent-friendly contraceptive services. Data were coded with MAXQDA and analyzed using a framework for contraceptive decisionmaking to identify relevant patterns and themes. Results In all three countries, youth reported that condoms are the most commonly sought contraceptive method because they are easiest to access and because youth have limited knowledge of other methods. Youth from diverse settings shared uncertainty and concern about the safety and side effects of many methods other than condoms, complicating their ability to take full advantage of other available methods. While most youth in Kenya, Nigeria, and Uganda reported at least moderate confidence in obtaining the information needed to help choose a method, and only a few youth reported that they are completely unable to access contraceptives, other barriers still present a major deterrent for youth, including cost, inconvenient facility hours and long wait times, and stigma from family, community members, and providers. Conclusions Young people’s ability to fully exercise their method choice remains limited despite availability of services, leading them to take the path of least resistance. Program implementers and policymakers should consider the diverse and often interconnected barriers that youth face in attempting to enjoy the benefits of a full spectrum of contraceptive methods and design multi-level interventions to mitigate such barriers.

scholarly journals Influence of Religion and Religiosity on Fertility and Contraceptive Use in Continental Sub-Saharan Africa: A Comprehensive Review

2021 ◽  
Author(s):  
Nicola Turner
Keyword(s):  
Family Planning ◽  
Contraceptive Use ◽  
Negative Relationship ◽  
Qualitative Studies ◽  
Sub Saharan Africa ◽  
Religious Leaders ◽  
Group Discussions ◽  
Sub Saharan ◽  
Indigenous Religions ◽  
Depth Interviews

The global human population has been increasing at an alarming rate over the last 100 years and is projected by the United Nations (UN) to continue to increase and reach 10 billion by 2057, despite a declining growth rate. Although some countries and regions, primarily Japan and Europe, have stabilised or declining populations, Sub-Saharan Africa is dramatically growing at an annual rate of 2.7% as of 2019, and is projected to sustain a rapid population growth up to 2100. Addressing the subject of population growth and overpopulation is an important but unfortunately neglected task. The consequences of a large, growing human population are already having distressing impacts on the planet, both on the natural environment and on humans, especially women and children. Until recently, there have been few studies on the effects of religion and religiosity on fertility and contraceptive use, and these factors are often overlooked as possible determinants. The aim of this review is to explore and seek to clarify the role of religion and religiosity on fertility and contraceptive use in continental Sub-Saharan African countries. The review of quantitative publications supported by insights and opinions from actual quotes of respondents from qualitative studies shows that followers of African Indigenous Religions and Islam have higher fertility rates than followers of Christianity. Across Christian denominations, Catholics generally had higher fertility than Protestants although the difference is small. Followers of the Apostolic Church exhibited the highest fertility among Christian groups. Focus group discussions and in-depth interviews from the qualitative studies found that religious beliefs were frequently cited as a barrier to contraceptive uptake. The findings clearly suggest that religion influences fertility and contraceptive use, although countries differ in this respect. Few studies mentioned religiosity; existing results show a positive relationship across Sub-Saharan Africa between degree of religiosity and fertility, and a negative relationship with contraceptive use. These relationships are stronger in Islamic and Indigenous religions compared with Christianity. Religious leaders across all religions were found to be highly influential and many participants were inclined to follow the recommendations of religious leaders regarding fertility and contraceptive use. The implication of this finding is that educating religious leaders about rights-based family planning and its benefits should be part of a comprehensive strategy to increase contraceptive uptake and reduce fertility. With knowledge of its benefits, religious leaders could spread accurate messages about family planning to their followers and promote higher contraceptive use and low fertility. In addition, other important socioeconomic and cultural factors influence fertility and contraceptive use. Education, economy and access to family planning have a negative relationship with religiosity, but the strength of this relationship varies depending on religion, residence and region, with Muslims generally reported as the most disadvantaged in terms of education and wealth across Sub-Saharan Africa. Polygyny, gender attitudes, social status and misconceptions about family planning were additional influences on fertility and contraceptive use mentioned in focus group discussions and in-depth interviews from the qualitative studies. Religion and religiosity have an important role to play in relation to fertility and contraceptive use, but they also depend on other factors, their interactions and their relative influences. They have variable relationships to education, economy, gender equality, residence (rural/urban) and access to family planning, due to the different levels of these factors among and within countries in Sub-Saharan Africa. The review suggests that with a more religiously open stance towards family planning, population policies can be more easily implemented. Religion and religiosity need to be considered in surveys and studies on fertility and contraceptive use to inform and help policymakers, economic planners, program managers, researchers and survey specialists. In addition, this has the potential to improve environmental conditions in Sub-Saharan Africa.

Monetary Policy in Sub-Saharan Africa

2018 ◽  
Keyword(s):  
Monetary Policy ◽  
Low Income ◽  
Sub Saharan Africa ◽  
Low Income Countries ◽  
African Countries ◽  
Policy Regimes ◽  
Export Prices ◽  
Policy Work ◽  
Sub Saharan ◽  
Policy Guidance

Having broadly stabilized inflation over the past two decades, many policymakers in sub-Saharan Africa are now asking more of their monetary policy frameworks. They are looking to avoid policy misalignments and respond appropriately to both domestic and external shocks, including swings in fiscal policy and spikes in food and export prices. In many cases they are finding current regimes—often characterized as ‘money targeting’—lacking, with opaque and sometimes inconsistent objectives, inadequate transmission of policy to the economy, and difficulties in responding to supply shocks. At the same time, little existing research on monetary policy is targeted to low-income countries. What do we know about the empirics of monetary transmission in low-income countries? (How) Does monetary policy work in countries characterized by a huge share of food in consumption, underdeveloped financial markets, and opaque policy regimes? (How) Can we use methods largely derived in advanced countries to answer these questions? And (how) can we use the results to guide policymakers? This book draws on years of research and practice at the IMF and in central banks from the region to shed empirical and theoretical light on these questions and to provide practical tools and policy guidance. A key feature of the book is the application of dynamic general equilibrium models, suitably adapted to reflect key features of low-income countries, for the analysis of monetary policy in sub-Saharan African countries.

scholarly journals COVID-19 pandemic: the implications of the natural history, challenges of diagnosis and management for care in sub-Saharan Africa

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Lawrence Omo-Aghoja ◽  
Emuesiri Goodies Moke ◽  
Kenneth Kelechi Anachuna ◽  
Adrian Itivere Omogbiya ◽  
Emuesiri Kohworho Umukoro ◽  
...  
Keyword(s):  
Public Health ◽  
Natural History ◽  
Low Income ◽  
Sub Saharan Africa ◽  
Low Income Countries ◽  
Diagnosis And Management ◽  
Severe Acute Respiratory Infection ◽  
Identification Technique ◽  
Sub Saharan ◽  
Policies And Programs

Abstract Background Coronavirus disease (COVID-19) is a severe acute respiratory infection which has afflicted virtually almost all nations of the earth. It is highly transmissible and represents one of the most serious pandemics in recent times, with the capacity to overwhelm any healthcare system and cause morbidity and fatality. Main content The diagnosis of this disease is daunting and challenging as it is dependent on emerging clinical symptomatology that continues to increase and change very rapidly. The definitive test is the very expensive and scarce polymerase chain reaction (PCR) viral identification technique. The management has remained largely supportive and empirical, as there are no officially approved therapeutic agents, vaccines or antiviral medications for the management of the disease. Severe cases often require intensive care facilities and personnel. Yet there is paucity of facilities including the personnel required for diagnosis and treatment of COVID-19 in sub-Saharan Africa (SSA). It is against this backdrop that a review of key published reports on the pandemic in SSA and globally is made, as understanding the natural history of a disease and the documented responses to diagnosis and management is usually a key public health strategy for designing and improving as appropriate, relevant interventions. Lead findings were that responses by most nations of SSA were adhoc, paucity of public health awareness strategies and absence of legislations that would help enforce preventive measures, as well as limited facilities (including personal protective equipment) and institutional capacities to deliver needed interventions. Conclusion COVID-19 is real and has overwhelmed global health care system especially low-income countries of the sub-Sahara such as Nigeria. Suggestions for improvement of healthcare policies and programs to contain the current pandemic and to respond more optimally in case of future pandemics are made herein.

scholarly journals Gestational weight gain in low-income and middle-income countries: a modelling analysis using nationally representative data

2020 ◽  
Vol 5 (11) ◽  
pp. e003423
Author(s):  
Dongqing Wang ◽  
Molin Wang ◽  
Anne Marie Darling ◽  
Nandita Perumal ◽  
Enju Liu ◽  
...  
Keyword(s):  
Weight Gain ◽  
North Africa ◽  
Low Income ◽  
Sub Saharan Africa ◽  
Middle Income ◽  
Middle Income Countries ◽  
Gestational Weight ◽  
Latin America And Caribbean ◽  
Nationally Representative ◽  
Sub Saharan

IntroductionGestational weight gain (GWG) has important implications for maternal and child health and is an ideal modifiable factor for preconceptional and antenatal care. However, the average levels of GWG across all low-income and middle-income countries of the world have not been characterised using nationally representative data.MethodsGWG estimates across time were computed using data from the Demographic and Health Surveys Program. A hierarchical model was developed to estimate the mean total GWG in the year 2015 for all countries to facilitate cross-country comparison. Year and country-level covariates were used as predictors, and variable selection was guided by the model fit. The final model included year (restricted cubic splines), geographical super-region (as defined by the Global Burden of Disease Study), mean adult female body mass index, gross domestic product per capita and total fertility rate. Uncertainty ranges (URs) were generated using non-parametric bootstrapping and a multiple imputation approach. Estimates were also computed for each super-region and region.ResultsLatin America and Caribbean (11.80 kg (95% UR: 6.18, 17.41)) and Central Europe, Eastern Europe and Central Asia (11.19 kg (95% UR: 6.16, 16.21)) were the super-regions with the highest GWG estimates in 2015. Sub-Saharan Africa (6.64 kg (95% UR: 3.39, 9.88)) and North Africa and Middle East (6.80 kg (95% UR: 3.17, 10.43)) were the super-regions with the lowest estimates in 2015. With the exception of Latin America and Caribbean, all super-regions were below the minimum GWG recommendation for normal-weight women, with Sub-Saharan Africa and North Africa and Middle East estimated to meet less than 60% of the minimum recommendation.ConclusionThe levels of GWG are inadequate in most low-income and middle-income countries and regions. Longitudinal monitoring systems and population-based interventions are crucial to combat inadequate GWG in low-income and middle-income countries.

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